Individual
DR. MATTHEW E. RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1336 CRESTON PARK DR, JANESVILLE, WI 53545-1119
(608) 755-1082
Mailing address
215 E HOLMES ST, JANESVILLE, WI 53545-3909
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5726-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33787800
—
WI
Enumeration date
07/17/2006
Last updated
08/14/2008
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